Devices for delivering bone filler material and associated methods of use

ABSTRACT

Methods and apparatus for treating bones, including, in one or more embodiments, a device for delivering a bone filler material comprising: a housing having a throughbore; a plunger comprising a shaft having external threads, wherein the plunger is configured for advancement through the throughbore of the housing; and a threaded receiving member configured to releasably engage the plunger. Methods for removing an instrument from a vertebral body comprising applying ultrasonic energy to the instrument, wherein a distal end of the instrument is disposed in a cavity in the vertebral body, wherein the cavity contains a filler material; and removing the instrument from the vertebral body.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/561, 246 filed Dec. 5, 2014 which is a continuation of U.S. patentapplication Ser. No. 14/036,934 filed Sep. 25, 2013, which issued asU.S. Pat. No. 8,932,297, which is a divisional of U.S. patentapplication Ser. No. 12/813,712 filed on Jun. 11, 2010, which issued asU.S. Pat. No. 8,568,420, the contents of these applications beingincorporated herein by reference in their entireties for all purposes.

FIELD OF THE INVENTION

The present disclosure generally relates to treatment of bones. Inparticular, in one or more embodiments, the present disclosure relatesto a device for delivering bone filler material that includes a plungerand a threaded receiving member configured to releasably engage theplunger.

BACKGROUND OF THE INVENTION

Bones and bony structures are susceptible to a variety of weaknessesthat can affect their ability to provide support and structure.Weaknesses in bony structures may have many causes, includingdegenerative diseases, tumors, fractures, and dislocations. By way ofexample, weaknesses in vertebrae can lead to compression fractures thatinvolve the collapse of one or more vertebrae in the spine. Thesevertebral compression fractures may be caused by a number of conditionsincluding osteoporosis, trauma, and tumors. Advances in medicine andengineering have provided doctors with a plurality of devices andtechniques for alleviating or curing these weaknesses.

One technique for treating vertebral fractures is vertebroplasty. Invertebroplasty, a physician may use a needle to inject filler material(e.g., bone cement) into a fractured vertebral body to stabilize thefracture. Kyphoplasty is another technique for treating vertebrafractures that involves insertion of a balloon into the fracturedvertebra to restore the height of the vertebra. The balloon may then beremoved followed by injection of filler material into the vertebral bodyto stabilize the fracture.

A number of different devices have been developed for injection offiller material into fractured vertebrae. For example, syringe-typedevices have been used that comprise a plunger and a chamber. Thephysician manually advances the plunger to eject tiller material fromthe chamber. Drawbacks to syringe-type devices include problemsgenerating the necessary pressure to eject the filler material incertain applications. Additional drawbacks include precisely controllingthe volume of filler material ejected from the chamber. Mechanicaldevices have also been used for the injection of filler material thatmay include, for example, a housing that supports a cartridge containingbone cement. The mechanical devices further may include a plunger thatforces the filler material from the cartridge. The ram may be activatedby a trigger mechanism or screwing mechanism, for example.

Thus, there is a need for methods and devices that can be used todeliver bone filler material.

SUMMARY OF THE INVENTION

An embodiment may comprise a device for delivering a bone fillermaterial. The device may comprise a housing having a throughbore. Thedevice may further comprise a plunger comprising a shaft having externalthreads. The plunger may be configured for advancement through thethroughbore of the housing. The device may further comprise a threadedreceiving member configured to releasably engage the plunger.

The features and advantages of the present invention will be readilyapparent to those skilled in the art. While numerous changes may be madeby those skilled in the art, such changes are within the spirit of theinvention.

BRIEF DESCRIPTION OF THE DRAWINGS

These drawings illustrate certain aspects of the present invention andshould not be used to limit or define the invention.

FIGS. 1-3 illustrate a device for delivering bone filler material inaccordance with one embodiment of the present invention,

FIG. 4 illustrates a plunger for use in a device for delivering bonefiller material in accordance with one embodiment of the presentinvention.

FIGS. 5-7 illustrate a device for delivering bone filler material inaccordance with alternative embodiments of the present invention.

FIGS. 8-10 illustrate a device for delivering bone filler material inaccordance with alternative embodiments of the present invention.

FIGS. 11-12 illustrate an actuator assembly for se in a device fordelivering bone tiller material in accordance with one embodiment of thepresent invention.

FIGS. 13-14 illustrate a device for delivering bone filler material inaccordance with alternative embodiments of the present invention.

FIG. 15 illustrates a device for delivering bone filler material with aflexible extension tube connecting the device to a cannula in accordancewith one embodiment of the present invention.

FIG. 16 illustrates a device for delivering bone filler material with arigid extension tube connecting the device to a cannula in accordancewith one embodiment of the present invention,

FIGS. 17-19 illustrate an embodiment of the present invention in whichultrasonic energy is used in the removal of a cannula from a vertebralbody.

DETAILED DESCRIPTION OF THE INVENTION

FIGS. 1-3 illustrate a device 10 for delivering a bone filler materialin accordance with one embodiment of the present invention. Asillustrated, the device 10 may include a plunger 12, a housing 14, and ahandle 16. In an embodiment, a tube 18 containing filler material may becoupled to the housing 14. The plunger 12 may be advanced through thehousing 14 to eject the filler material from the tube 18. As will bediscussed in more detail below, the plunger 12 may be advanced byrotation of the plunger 12 or by pushing the plunger 12 in the axialdirection.

FIG. 4 illustrates an embodiment of the plunger 12. As illustrated, theplunger 12 generally has a proximal end 20 and a distal end 22. In theillustrated embodiment, the plunger 12 may include a plunger handle 24at the proximal end 20 of the plunger 12. The plunger 12 may furtherinclude a shaft 26. At least a portion of the shaft 26 may includeexternal threads 28. The plunger 12 may further include a stop 30configured to displace filler material from the tube 18, which may belocated at the distal end 22 of the plunger. As illustrated, the stop 30may have a larger external diameter than the shaft 26. In an embodiment,the shaft 26 may extend from the plunger handle 24 to the stop 30.

Referring again to FIGS. 1-3, the housing 14 may include a throughbore32 in accordance with one embodiment of the present invention. Asillustrated, the throughbore 32 may extend from anterior face 34 toposterior face 36 of the housing 14. In an embodiment, the plunger 12may be advanced through the throughbore 32. As illustrated, the housing14 may further include chamber 38 in the interior of the housing 14 thatintersects the throughbore 32. Upper receiving member 40 and lowerreceiving member 42 may be disposed in the chamber 38. Upper receivingmember 40 may contain upper inner threads 44, and lower receiving membermay contain lower inner threads 46 such that the upper receiving member40 and the lower receiving member 42 generally may form a threaded bore.The upper inner threads 44 and lower inner threads 46 may becomplementary with and generally configured to mate with the externalthreads 28 on the plunger 12.

A recess 48 may be formed off of the chamber 38. As illustrated, therecess 48 may be formed off a lower portion of the chamber 38. Spring 50may be disposed in the recess 48 with spring 50 extending from therecess 48 to engage the lower receiving member 42. In an embodiment,spring 50 biases the lower receiving member 42 into engagement with theplunger 12 such that the lower inner threads 46 on lower receivingmember 42 are in engagement with the external threads 28 on the plunger12. In the illustrated embodiment, actuator 52 extends from chamber 38through the upper face 54 of the housing 14. Actuator 52 may be engagedwith the lower receiving member 42 such that when the actuator 52 isdepressed the lower inner threads 46 disengage from the plunger 12. Whenpressed, the actuator 52 should apply pressure to the spring 50 suchthat the spring 50 no longer applies sufficient pressure on the lowerreceiving member 42 for the lower inner threads 46 to engage exteriorthreads 28 of the plunger 12. Accordingly, the exterior threads 28 ofthe plunger 12 may be considered to be releasably engaged with the lowerinner threads 46 of the lower receiving member 42 because they can bedisengaged without rotation of the plunger 12. In other words, the lowerreceiving member 42 is configured to releasably engage the exteriorthreads 28 of the plunger 12.

Housing 14 further may include a slot 56 for engaging the tube 18. Theslot 56 may intersect the throughbore 32. In general, the slot 56 may beconfigured to hold the tube 18 in axial alignment with the throughbore32. While FIGS. 1-3 illustrate housing 20 as being generally rectangularin shape, it should be understood that the present invention encompassesother suitable configurations for housing 20, including, for example,cylindrically shaped housings.

The handle 16 may be coupled to the housing 14 in accordance with oneembodiment of the present invention. As illustrated, the handle 16 mayinclude a post 58 about which a handle grip 60 is disposed. In anembodiment, distal end 62 of the post 58 may be disposed through a lowerface 64 of the housing 14 to secure the handle 16 to the housing 14.

The tube 18 may be coupled to the housing 14 in accordance with oneembodiment of the present invention. As illustrated, the tube 18 mayinclude a rim 66 that may be received by the slot 56. The rim 66generally should secure the tube 18 to the housing 14. The tube 18 mayfurther include a chamber 68 for receiving the filler material. The tube18 further may include an exit port 70 through which the filler materialmay be ejected. In an embodiment, the tube 18 may be constructed from aclear, plastic material. In an embodiment, the tube 18 may bedisposable. It should be understood, that the device 10 may be suppliedwithout the tube 18 in accordance with embodiments of the presentinvention. For example, the tube 18 containing the filler material maybe supplied by the physician prior to use.

To eject filler material from the exit port 70 of the tube 18, theplunger 12 can be advanced through the housing 14 and into the tube 18.As the plunger 12 advances through the tube 18, filler material may bedisplaced out through the exit port 70. The plunger 12 can be axiallypushed or rotated through the housing 14 to advance into the tube 18 inaccordance with present embodiments. In an embodiment, the plunger 12can be moved along the longitudinal axis 72 of the throughbore 32 byrotating the plunger 12 such that the exterior threads 28 of the plunger12 engage the upper and lower interior threads 44, 46 of the upper andlower receiving members 40, 42. The plunger handle 24 may be used tofacilitate rotation of the plunger 12. In another embodiment, theplunger 12 can be advanced through the housing 14 and into the tube 18by pushing the plunger 12 in the axial direction. Before the plunger 12can be pushed in the axial direction, the actuator 52 should first bepushed to release lower interior threads 46 of the lower receivingmember 42. Otherwise engagement of the lower interior threads 46 withthe exterior threads 28 of the plunger 12 will prevent movement of theplunger 12 in the axial direction without rotation. To retract theplunger 12 into the housing 14, the plunger 12 can be axially pushed orrotated back through the housing 14 in a similar manner.

FIGS. 5-7 illustrate device 10 for delivering a bone tiller material inaccordance with an alternative embodiment of the present invention. Asillustrated, the device 10 may include plunger 12 and housing 14. In anembodiment, the tube 18 containing filler material may be coupled to thehousing 14. As previously mentioned, the plunger 12 may be advancedthrough the housing 14 and into the tube 18 by rotation or axiallypushing to eject the filler material.

In the embodiment illustrated by FIGS. 5-7, the housing 14 includes amain body 73 and a handle portion 74 that extends from the main body 73.The main body 73 may include a throughbore 32. As illustrated, thethroughbore 32 may extend from anterior face 34 to posterior face 36 ofthe main body 73. In an embodiment, the plunger 12 may be advancedthrough the throughbore 32. As illustrated, the housing 14 may furtherinclude an upper chamber 76 in the interior of the housing 14 thatintersects the throughbore 32. Receiving member 78 may be disposed inthe upper chamber 76. In the illustrated embodiment, receiving member 78includes rod portion 80 and inner threaded portion 82. Throughbore 32may further contain upper threads 83 which generally may form a threadedbore with the inner threaded portion 82. The inner threaded portion 82and upper threads 83 may be complementary with and generally configuredto mate with the external threads 28 on the plunger 12. Receiving member78 may translate within the upper chamber 76 from an engaged position toa disengaged position. in the engaged position, the inner threadedportion 82 of the receiving member 78 should engage the external threads28 of the plunger 12. In the disengaged position, the receiving member78 should be positioned lower in the upper chamber 76 such that theinner threaded portion 82 is not engaged with the external threads 28 ofthe plunger 12.

Actuator rod assembly 84 may be mounted in the handle portion 74 of thehousing 14. Actuator rod assembly 84 has a proximal end 86 and distalend 88. Actuator rod assembly 84 may comprise actuator rod 90, actuatorspring 92, and actuator handle 94. In the illustrated embodiment, theactuator rod 90 extends from the upper chamber 76 of the housing 14 outthrough the bottom 96 of the handle portion 74. Actuator rod 90 mayinclude threads 98 on the proximal end 86, for example, that are inthreaded engagement with the handle portion 74 of the housing 14.Actuator spring 92 may be disposed over the actuator rod 90 on thedistal end 88 of the actuator rod assembly 84 to engage the receivingmember 78. In an embodiment, actuator spring 92 biases the receivingmember 78 into engagement with the plunger 12 such that the innerthreaded portion 82 of the receiving member 78 is in engagement with theexternal threads 28 on the plunger 12. In the illustrated embodiment,actuator handle 94 (e.g., a knob) is disposed on the proximal end of theactuator rod assembly 84. Actuator handle 94 may be activated to lowerthe actuator rod 90 thereby releasing the pressure applied to thereceiving member 78 by the actuator spring 92. In this manner, theactuator handle 94 can be activated to disengage the inner treadedportion 82 of the receiving member 78 from the plunger. The actuatorhandle 94 may be activated, for example, by rotation.

To eject filler material from the exit port 70 of the tube 18, theplunger 12 can be advanced through the main body 73 of the housing 14and into the tube 18. As the plunger 12 advances through the tube 18,filler material should be displaced out through the exit port 70. Theplunger 12 can be axially pushed or rotated through the housing 14 toadvance into the tube 18. In an embodiment, the plunger 12 can be movedalong the longitudinal axis 72 of the throughbore 32 by rotating theplunger 12 such that the exterior threads 28 of the plunger 12 engagethe inner threaded portion 82 of the receiving member 78 and upperthreads 83 of the main body 73. The plunger handle 24 may be used tofacilitate rotation of the plunger 12. In another embodiment, theplunger 12 can be advanced through the housing 14 and into the tube 18by pushing the plunger 12 in the axial direction. Before the plunger 12can be pushed in the axial direction, the actuator rod assembly 84should first be activated to release the inner threaded portion 82 ofthe receiving member 78. Otherwise engagement of the inner threadedportion 82 with the exterior threads 28 of the plunger 12 will preventmovement of the plunger 12 in the axial direction without rotation. Theactuator rod assembly 84 may be activated by rotation of the activatorhandle 94, for example. To retract the plunger 12 into the housing 14,the plunger 12 can be axially pushed or rotated back through the housing14 in a similar manner.

FIGS. 8-10 illustrate device 10 for delivering a bone filler material inaccordance with an alternative embodiment of the present invention. Asillustrated, the device 10 may include plunger 12, housing 14, andhandle 16. In an embodiment, tube 18 containing filler material may becoupled to the housing 14. As previously mentioned, the plunger 12 maybe advanced through the housing 14 and into the tube 18 by rotation oraxially pushing to eject the filler material.

in the embodiment illustrated by FIGS. 8-10, the housing 14 includesmain body 73 and a receiving member 100 coupled to the main body 73. Themain body 73 may include a throughbore 32. Receiving member 100 may bedisposed in a slot (not illustrated) in the rear face 36 of the mainbody 73. Receiving member 100 may comprise body 102, trigger 104, andspring 106. Body 102 may comprise bore 108 that extends through the body102. As illustrated by FIGS. 11-12, the bore 108 may comprise a firstthreaded portion 110 and a second threaded portion 112. In theillustrated embodiment, the first threaded portion 110 is in the upperportion of the bore 108 and the second threaded portion 112 is in thelower portion of the bore 108. As illustrated, the first smooth flaredsection 120 may be opposite the first threaded portion, and the secondsmooth flared section 122 may be opposite the second threaded portion112. Referring again to FIGS. 8-10, spring 106 may be mounted in thehousing 14. The spring 106 should bias the first threaded portion 110and the second threaded portion 112 into engagement with the plunger 12such that first and second threaded portions 110, 112 are in engagementwith the external threads 28 of the plunger 12. When biased, the firstand second threaded portions 110, 112 of bore 108 generally should forma threaded bore that is axially aligned with throughbore 32 of main body73. The first and second threaded portions 110, 112 may be complementarywith and generally configured to mate with the external threads 28 onthe plunger 12. At least one fulcrum 114 may be attached to the body102. In the embodiment illustrated by FIGS. 8-10, the at least onefulcrum 114 is in the form of two pins that are disposed through atleast one opening 116 in the main body 73 to engage the body 102. Body102 can pivot about the at least one fulcrum 114 against the biasing ofthe spring 106.

FIGS. 11-12 illustrate the receiving member 100 in more detail inaccordance with one embodiment of the present invention. In theillustrated embodiment, a second protrusion 118 extends from the body102. As illustrated, the trigger 104 and the second protrusion 118 maybe in the form of tabs extending from the body 102 giving the receivingmember 100 a generally T-shaped cross section. Bore 108 may comprise afirst threaded portion 110. In the illustrated embodiment, the firstthreaded portion 110 is located on the upper portion in the first halfof the bore 108. Bore 108 may comprise a second threaded portion 112. Inthe illustrated embodiment, the second threaded portion 112 is locatedon the lower portion in the second half of the bore 108. As illustrated,the bore 108 may have a first smooth flared section 120 and a secondsmooth flared section 122. First smooth flared section 120 may be in thelower portion in the first half of the bore 108. Second smooth flaredsection 122 may be in the upper portion in the second half of the bore108.

FIG. 11 illustrates the receiving member 100 with the body 102 biased byspring 106 (FIG. 10) in accordance with one embodiment of the presentinvention. As illustrated, the first and second threaded portions 110,112 should generally form a threaded bore that is axially aligned withthroughbore 32 of main body 73 when biased. In this manner, the firstand second threaded portions 110, 112 may be in engaged with theexternal threads 28 of the plunger 12 (FIG. 10). The receiving member100 may be considered in a receiving member in that the receiving member100 is configured to receive the plunger 12 in certain embodiments.

FIG. 12 illustrates the receiving member 100 with the body 102 pivotedagainst the biasing of the spring 106 (FIG. 10) in accordance with oneembodiment of the present invention. In an embodiment, the trigger 104may be pressed against the spring 106 to pivot the body 102. Whenpivoted, the first and second threaded portions 110, 112 generallyshould disengage from the external threads 28 of the plunger 12 (FIG.10) with the first smooth flared section 120 and the second smoothflared section 122 allowing axial translation of the plunger 12 withoutrotation.

To eject filler material from the exit port 70 of the tube 18, theplunger 12 can be advanced through the body 102 of the receiving member100, through the throughbore 32 of the main body 73, and into the tube18. As the plunger 12 advances through the tube 18, filler materialshould be displaced out through the exit port 70. The plunger 12 can beaxially pushed or rotated through the housing 14 to advance into thetube 18 in accordance with present embodiments. In an embodiment, theplunger 12 can be advanced through the receiving member 100 and the mainbody 73 by rotating the plunger 12 such that the exterior threads 28 ofthe plunger 12 engage the threaded bore formed by the first and secondthreaded portions 110, 112 in the bore 108. The plunger handle 24 may beused to facilitate rotation of the plunger 12. In another embodiment,the plunger 12 can be advanced into the tube 18 by pushing the plunger12 in the axial direction. Before the plunger 12 can be pushed in theaxial direction, the first and second threaded portions 110, 112 shouldbe disengaged. Otherwise engagement of the first and second threadedportions 110, 112 of the bore 108 with the exterior threads 28 of theplunger 12 will prevent movement of the plunger 12 in the axialdirection without rotation. To disengage the first and second threadedportions 110, 112, the body 102 should be pivoted against the biasing ofthe spring 106. For example, the trigger 104 can be pressed against thespring 106 to pivot the body 102 about the at least one fulcrum 114. Asthe body 102 pivots the first and second threaded portions 110, 112should disengage from the exterior threads 28 releasing the plunger 12and allowing axial translation of the plunger 12 in the throughbore 32.To retract the plunger 12 into the housing 14, the plunger 12 can beaxially pushed or rotated back through the housing 14 in a similarmanner.

FIGS. 13-14 illustrate device 10 for delivering a bone filler materialin accordance with an alternative embodiment of the present invention.As illustrated, the device 10 may include plunger 12 and housing 14. Inan embodiment, the tube 18 containing filler material may be coupled tothe housing 14, As previously mentioned, the plunger 12 may be advancedthrough the housing 14 and into the tube 18 by rotation or axiallypushing to eject the filler material.

In the embodiment illustrated by FIGS. 13-14, the housing 14 may includea flanged end 124, body 126, and one or more wings 128. The body 126 mayinclude a throughbore 32 through which the plunger 12 may be advanced.In the illustrated embodiment, the body 126 is generally cylindrical inshape. The wings 128 are configured to project from the body 126 of thehousing 14 when in a disengaged position, as illustrated by FIG. 13. Thewings 128 may be considered a receiving member in that the wings 128 areconfigured to receive the plunger 12 when in an engaged position, asillustrated by FIG. 14. In an embodiment, the wings 128 contain interiorthreads 130 that are configured to releasably engage the exteriorthreads 28 of the plunger 12. In general, the interior threads 130 onthe wings 128 may be complementary with and generally configured to matewith the external threads 28 on the plunger 12. Collar 132 may bedisposed on the housing 14. Collar 132 may be configured to move on thehousing 14 to force the wings 128 into engagement with the plunger 12.FIG. 13 illustrates the wings 128 in a disengaged position in accordancewith one embodiment of the present invention. As illustrated, the wings128 may project away from the body such that the interior threads 130 donot engage the exterior threads 28 of the plunger 12. FIG. 14illustrates the wings 128 in an engaged position in accordance with oneembodiment of the present invention. As illustrated, the collar 132 maybe slid over the wings 128 forcing the interior threads 130 intoengagement with the exterior threads 28 of the plunger 12.

To eject filler material from the exit port 70 of the tube 18, theplunger 12 can be advanced through the body 126 of the housing 14 andinto the tube 18. As the plunger 12 advances through the tube 18, fillermaterial should be displaced out through the exit port 70. The plunger12 can be axially pushed or rotated through the housing 14 to advanceinto the tube 18. in an embodiment, the plunger 12 can be moved alongthe longitudinal axis 72 of the throughbore 32 by rotating the plunger12 such that the exterior threads 28 of the plunger 12 engage theinterior threads 130 of the wings 128. The plunger handle 24 may be usedto facilitate rotation of the plunger 12. For the wings 128 to receivethe plunger 12, the wings 128 should be in the engaged position with thecollar 132, for example, applying pressure to the wings 128. In anotherembodiment, the plunger 12 can be advanced through the housing 14 andinto the tube 18 by pushing the plunger 12 in the axial direction.Before the plunger 12 can be pushed in the axial direction, the wings128 should be in the disengaged position with the collar 132, forexample, slid off the wings 128 such that wings are released to projectout from the body 126. Otherwise engagement of the interior threads 130with the exterior threads 28 of the plunger 12 will prevent movement ofthe plunger 12 in the axial direction without rotation. To retract theplunger 12 into the housing 14, the plunger 12 can be axially pushed orrotated back through the housing 14 in a similar manner.

FIG. 15 illustrates introduction of filler material into vertebral body134 with device 10 in accordance with one embodiment of the presentinvention. As illustrated, cannula 136 may be inserted into cavity 138in vertebral body 134. Cannula 136 may provide an access corridor intothe cavity 138. Extension tube 140 may be coupled to the cannula 136. Inaccordance with present embodiments, the extension tube 140 may beconfigured to allow physician to use the device 10 while staying out ofthe radiation field during fluoroscopy. Extension tube 140 may have aproximal end 142 and a distal end 144. The distal end 144 of theextension tube 140 may be coupled to the cannula 136. In an embodiment,the extension tube 140 may be a flexible tube. In an embodiment, theextension tube 140 may be a rigid tube, as illustrated by FIG. 16. Asillustrated, the extension tube 140 may be bent. The proximal end 142 ofthe extension tube 140 may be coupled to the device 10. As illustrated,the extension tube 140 may be coupled to the tube 18 containing fillermaterial. In an embodiment, a luer fitting 146 couples the extensiontube 140 to the tube 18. To inject filler material into the vertebralbody 134, the plunger 12 may be advanced. The plunger 12 should forcethe filler material from the tube 18, through the extension tube 140 andcannula 136, and into the vertebral body 134. As discussed above, theplunger 12 may be advanced by rotation of the plunger 12 or by pushingthe plunger 12 in the axial direction.

As previously mentioned, filler material (e.g., bone cement) can beinjected into a vertebral body 134 and through a cannula 136 inaccordance with embodiments of the present invention. In embodiments,the device 10 can be used to deliver the filler material. After thetiller material has been introduced, the cannula 136 can be removed fromthe vertebral body 134. However, removal of the cannula 136 can beproblematic, for example, if the cannula 136 has become stuck on thecured filler material. Accordingly, embodiments of the present inventionprovide a technique of utilizing ultrasound to facilitate removal of thecannula 136 from the vertebral body 134. FIGS. 17-19 illustrate anembodiment for removing the cannula 136 from the vertebral body 134.While the present discussion is directed to cannula 136 removal, itshould be understood that ultrasound may be to facilitate removal ofother instruments that may be used in a surgical procedure.

FIG. 17 illustrates cannula 136 disposed in vertebral body 134 inaccordance with one embodiment of the present invention. Cavity 138 inthe vertebral body 134 contains filler material 141. In accordance withpresent embodiments, the filler material 141 may have set to form ahardened mass in the cavity 138. The distal end 148 of the cannula 136extends into the filler material 141 that is present in the vertebralbody 134.

FIG. 18 illustrates an embodiment of the present invention in whichultrasound energizer 143 is used to deliver ultrasonic energy to thecannula 136. The ultrasound energizer 143 may be any of a variety ofdevices suitable for generating ultrasonic energy. As illustrated, anultrasound adapter 145, contacting the cannula 136, may be coupled tothe ultrasound energizer 143. In the illustrated embodiment, theultrasound adapter 145 includes an attachment end 147 for coupling theultrasound adapter 145 to the cannula 136. As illustrated, theattachment end 147 may be generally u-shaped for receiving thetubular-shaped cannula 136. The ultrasound adapter 145 should generallytransfer the ultrasonic energy created by the ultrasound energizer 143to the cannula 136. It is believed that the vibrations in the cannulafrom the ultrasonic energy should generate frictional energy and, thus,heat, softening the set filler material 141 to ease removal of thecannula 136.

FIG. 19 illustrates removal of the cannula 136 from the vertebral body134 in accordance with one embodiment of the present invention. Once thefiller material 141 has been softened from application of the ultrasonicenergy to the cannula 136, axial force may be applied to remove thecannula 136 from the filler material 141 in the vertebral body 134.

The preceding description describes the introduction of a fillermaterial into a vertebral body in accordance with embodiments of thepresent invention. Those of ordinary skill in the art will appreciatethat the filler material may comprise any of a variety of materials thatmay be utilized to, for example, fill and stabilize a vertebral body.Examples of suitable materials may include bone cements (e.g. polymethylmethacrylate), human bone graft and synthetic derived bone substitutes.

In addition, the preceding description is directed, for example, to theintroduction of a filler material into a vertebral body for thetreatment of vertebral fractures. It should be understood that thepresent technique also may be used in other suitable treatments where afiller material is introduced into a bone. By way of example,embodiments of the present invention may be used to treat tibia plateaufractures, distal radius fractures, and cancellous fractures.

While it is apparent that the invention disclosed herein is wellcalculated to fulfill the objects stated above, it will be appreciatedthat numerous modifications and embodiments may be devised by thoseskilled in the art.

What is claimed is:
 1. A device for delivering a bone filler materialcomprising: a housing including a body having a throughbore and achamber that intersects the throughbore; a plunger comprising a shafthaving external threads, wherein the plunger is configured foradvancement through the throughbore of the housing; a receiving memberdisposed in the chamber and configured to releasably engage the plunger,the receiving member including an actuator rod assembly; the actuatorrod assembly including an actuator rod and an actuator spring, theactuator spring disposed over the actuator rod; and an actuator member,wherein the receiving member is configured to translate within thechamber from an engaged position where the receiving member engages theplunger to a disengaged position where the receiving member is notengaged with the plunger.
 2. The device of claim 1, wherein thethroughbore extends from an anterior face to a posterior face of thebody.
 3. The device of claim 1, wherein the receiving member includes aninner threaded portion.
 4. The device of claim 3, wherein the actuatormember is capable of being actuated to translate the actuator rodassembly.
 5. The device of claim 1, wherein the actuator rod assemblyand the receiving member are separate elements.
 6. The device of claim1, wherein the actuator rod assembly and the receiving member are notseparate elements.
 7. The device of claim 1, wherein the actuator springbiases the receiving member into engagement with the plunger.
 8. Thedevice of claim 1, wherein the actuator member is operatively engaged tothe actuator rod assembly.
 9. The device of claim 8, wherein theactuator handle is configured to lower the actuator rod to releasepressure applied to the receiving member by the actuator spring.
 10. Thedevice of claim 1 further comprising a tube coupled to the housing andconfigured to contain filler material.
 11. The device of claim 10,wherein the plunger is axially pushed through the housing and into thetube to eject the filler material from the device.
 12. The device ofclaim 10, wherein the plunger is advanced through the housing and intothe tube by rotation to eject the filler material from the device.
 13. Adevice for delivering a bone filler material comprising: a housingincluding a handle portion having a chamber and a body portion having athroughbore; a plunger comprising a shaft having external threads,wherein the plunger is configured for advancement through thethroughbore of the housing; a receiving member disposed in the chamberand configured to releasably engage the plunger, the receiving memberincluding an actuator rod assembly; the actuator rod assembly includingan actuator rod and an actuator spring, the actuator spring disposedover the actuator rod; and an actuator member, wherein the receivingmember is configured to translate within the chamber from an engagedposition where the receiving member engages the plunger to a disengagedposition where the receiving member is not engaged with the plunger, andwherein an upper portion of the receiving member includes threadingconfigured and dimensioned to threadingly engage the external threads ofthe plunger when the receiving member engages the plunger.
 14. Thedevice of claim 13 further comprising a tube having a chamber coupled tothe housing and configured to contain filler material.
 15. The device ofclaim 14, wherein the plunger is axially pushed through the housing andinto the tube to eject the filler material from the device.
 16. Thedevice of claim 14, wherein the plunger is advanced through the housingand into the tube by rotation to eject the filler material from thedevice.
 17. A device for delivering a bone filler material comprising: ahousing including a body having a throughbore and a chamber thatintersects the throughbore; a plunger configured for advancement throughthe throughbore of the housing, the plunger having an external thread; alower receiving member partially disposed in the chamber and configuredto releasably engage the plunger, wherein a spring biases the lowerreceiving member into engagement with the plunger; and an actuatorconfigured to engage the lower receiving member when the actuator isdepressed and applies pressure to the spring thereby disengaging thelower receiving member from the plunger, wherein when the lower receivermember is engaged with the plunger, the plunger is advanced by rotationand when the lower receiver member is not engaged with the plunger, theplunger is advanced by linear translation.
 18. The device of claim 17further comprising a tube having a chamber coupled to the housing andconfigured to contain filler material.
 19. The device of claim 18,wherein the plunger is axially pushed through the housing and into thetube to eject the filler material from the device.
 20. The device ofclaim 18, wherein the plunger is advanced through the housing and intothe tube by rotation to eject the filler material from the device.